Michael Moline, Author at Florida Politics - Page 6 of 27

Michael Moline

Michael Moline is a former assistant managing editor of The National Law Journal and managing editor of the San Francisco Daily Journal. Previously, he reported on politics and the courts in Tallahassee for United Press International. He is a graduate of Florida State University, where he served as editor of the Florida Flambeau. His family’s roots in Jackson County date back many generations.

Flood insurance, HMO liability legislation clear Senate committee

A Senate committee approved bills Tuesday that would encourage Florida insurers to write flood insurance as an alternative to expensive federal coverage, and would allow patients to sue HMOs for declining to cover doctors’ treatment recommendations in bad faith.

“Why shouldn’t the HMOs be held liable for the decisions they make and the doctors aren’t making, and people are dying? I just don’t think that’s equitable,” said Sen. Greg Steube, the Sarasota Republican behind SB 262, the HMO bill.

Existing law exempts HMOs from liability for treatment decisions by doctors with whom them contract to treat patients.

“What other businesses are prohibited by law from being sued from decisions they make that actually kill people?” Steube said following the committee’s 6-3 vote to approve his bill.

The measure would repeal legal protections for HMOs for vicarious liability for medical negligence unless the doctor is an employee. It also would create a cause of action for bad-faith refusal to provide a treatment recommended by a doctor.

Sen. Gary Farmer, a Democrat and a trial attorney from Broward County, said he entered the law after the mother of the best man at his wedding died after being denied a new treatment for the fatal side effects of chemotherapy and radiation treatments.

“I just do not believe a good-faith argument can be made that in a situation like that, an HMO cannot be held liable,” Farmer said.

Representatives of a number of medical professional organizations endorsed the bill, while insurance and business interests warned it would inflate coats for insurance companies and the state, through Medicaid and Medicare.

Sen. Rene Garcia, a Hialeah Republican, expressed sympathy with those qualms.

“It’s going to increase costs to the state and policyholders,” he said.

Sen. Jeff Brandes sponsored the flood insurance bill — SB 420.

Existing law allows insurers to offer flood policies through 2019 without having to wait for the Office of Insurance Regulation to review their rates. Brandes’ bill would extend that until 2025.

Farmer said he agreed with Brandes in theory, but worried the measure would encourage growth of unregulated surplus lines insurance — designed for “sophisticated” customers to protect against unique risks — “Liberace’s fingers. Dan Marino’s knees. Things of that nature.”

“We want more admitted carriers to write,” Brandes said following the 7-1 vote in favor his his bill. He referred to policies requiring pre-approval by regulators.

“But we also understand that surplus line carriers are writing, as well.”

And the bill encourages regulated insurers to enter the market.

“We’re offering them more flexibility in rates and forms. We’re making sure they are well-capitalized companies. But we want to create the right ecosystem for them to thrive in Florida.”

 

State economists see tourism growth canceling out lagging housing starts

Nothing emerged during a numbers-crunching exercise by state economists Tuesday to change the economic picture the Legislature will confront this year — growth in tourism and slack housing starts will offset each other as overall growth produces about $31 billion in general revenues.

“Those are going to compensate for each other. So, overall, you end up about where you were, on the same path where we were heading,” said Amy Baker, coordinator for the state Office of Economic and Demographic Research.

Together with unspent money left over from the current fiscal year, legislators will have about $32.3 billion in general revenues to spend during the fiscal year that begins July 1. That doesn’t count taxes and fees that feed trust funds dedicated to specific programs.

“Florida has been moving in lock step in line with our forecasts for several years now. We have not really had any big surprises. I think that will continue to be the case,” Baker said.

“It’s positive, from the fact that we continue to see some strength. But it’s not going to change what they’re facing this year.”

Gov. Rick Scott has proposed an $83.5 billion state budget for next fiscal year, but House appropriations subcommittees are taking a more pessimistic view of state revenues and are looking for programs to trim.

Economists from Baker’s office, the Legislature and the governor’s office reviewed data suggesting growth of about 4.5 percent in the tourism sector, notwithstanding declines in overseas visitors, including Canadians. Yet a long-anticipated increase in housing starts has yet to materialize.

Multifamily housing starts ought to be growing faster than they are, Baker said — particularly given young people’s penchant to cluster in rental apartments in cities. The economists suspected a lag time to put together construction deals. Or perhaps builders were awaiting the results of the presidential election.

Overall, construction “is growing with population growth, because our population is growing. But the amount it grows per new person is pretty steady,” Baker said.

“Even with the ginormous growth rate we’ve had — we’ve had double-digit growth rates for three of the last four years — we’re still nowhere back to normal.”

The prospect is for weak private housing starts through next fiscal year. “But then we have really good growth rates next year. So you’re coming back to where we were” before the recession “and going slightly ahead” in years to come.

Zika virus has not seriously crimped tourism, but Baker hadn’t expected that it would yet. The economists last considered the Zika factor last fall — going into the winter, when mosquito activity declines.

“The question is, as we go back into a higher period of time for mosquito activity, will we start off with no Zika effect or will we get back pretty fast to where we were, with an increase,” she said.

“Because we think of it as a black swan” — a big surprise — “we’re not building a Zika problem into our forecast. But that would be a threat because it’s such a strong part of our forecast.”

Bill Nelson seems undaunted by prospect of primary challengers

Is Sen. Bill Nelson up for a contested Democratic primary in his re-election bid next year?

“You want to do a contest on pull-ups or push-ups?” Nelson replied to a reporter who asked that question during an informal news conference in Tallahassee Monday.

News reports have mentioned Tim Canova, who tried and failed to replace Debbie Wasserman Schultz in Congress, former U.S. Senate candidate Pam Keith, and state Sen. Randolph Bracy as primary challengers to Nelson, 74, widely seen as a moderate at a time when his party is enflamed by anti-Donald Trump fervor.

Nelson pointed to 2000, when Republicans lured state House Democratic leader Willie Logan into an independent race, hoping to divert enough African American votes to throw the election to replace retiring U.S. Sen. Connie Mack to their candidate.

“With about five candidates in the race, he got something like 1 percent of the vote,” Nelson said.

Nelson visited Tallahassee to speak to STEM students at Florida A&M University and deliver a pep talk to the Senate Democratic caucus.

“My message is going to be: It’s worth it to keep fighting for your values.”

He acknowledged re-election won’t be easy — particularly if Gov. Rick Scott gets in as expected and invests some of his personal fortune.

“We have to assume that the Democratic candidates for governor and in my race for the Senate will always be outspent,” Nelson said.

“In the federal races, you have so many of these unlimited, undisclosed PACs. It makes it harder for me to raise large sums of money. Until the Supreme Court changes that or Congress does, it will be an imbalance.”

Will Trump be a factor?

“You’re guess is as good as mine,” he said.

Democratic senators must defend 10 states that Trump won, including Florida. Nelson observed that many of those margins were quite close — 116,000 in Florida, 50,000 in Pennsylvania, 30,000 in Michigan, and 10,000 in Wisconsin.

And this — “You omitted the big factor. Charles Schumer. He’s a money-making machine,” Nelson said, referring to his Senate party leader.

He praised Stephen Bittel, the new chairman of the Florida Democratic Party for his fundraising ability — not easy, he said, in a state where Republicans dominate government and the lobbying corps.

“Stephen, he’ll go around the lobbying corps,” Nelson said. “He’ll go to all his outside contacts.”

Nelson talked up legislation he and Marco Rubio have filed that would require the U.S. Army Corps of Engineers to reassess and redistribute shares of the Chattahoochee-Flint-Apalachicola river system to be fair to Alabama, Florida, and Georgia.

And he warned that turning Medicaid into a block grant program, as many Republicans in Washington and Tallahassee would like to do, would deal a “double whammy” on poor people in states like Florida, which didn’t expand coverage under the Affordable Care Act.

Nursing homes fighting plan to eliminate certificate of need program

The top legislative priority for Florida’s nursing homes this year is to kill a proposal, backed by Gov. Rick Scott, to repeal a requirement that they demonstrate a demand for new beds before they can expand or build new facilities.

SB 676, by Rob Bradley, and CS/HB 7 by Alex Miller, and would eliminate the certificate of need program at the Agency for Health Care Administration for all health care facilities.

Eliminating the requirement for nursing homes “would be extremely disruptive,” Florida Health Care Association chief lobbyist Bob Asztalos told reporters during a briefing Monday.

The association, which represents 82 percent of the skilled nursing facilities in Florida, fears competition from newer, shinier “Taj Mahal” facilities would drive down occupancy rates.

That’s what happened in Texas, where the occupancy rate hit 70 percent after the state scrapped its certificate of occupancy requirement, Asztalos said.

In Indiana, eliminating the requirement led to the construction of “so many buildings that they were looking at taxpayer money to buy buildings to take them off line,” he said.

“We don’t want to see Florida make the same mistakes,” Asztalos said.

Staffing levels would be “watered down,” said Rob Greene, CEO of Palm Garden Healthcare, which operates a network of facilities.

The association would like to see expansion limited to about 3,750 beds through July 2017, targeted to areas where they’re needed.

Free-market advocates, including Scott, argue an open marketplace would lower costs and increase quality.

“The government sets our rates. If there were a true free market, we would set our rates that the state would pay us for our care. But how do you have a free market where they set our rates?” Asztalos said.

The existing system is in the best interests of nursing homes, he conceded, but it also serves the state’s policy of placing patients in home- or community-based care.

“It’s not like nursing home A is going to steal beds from nursing home B. You’re going to look for people with high acuity who are in assisted living facilities, who are eligible for nursing home care or in home- or community-based care.”

“It’s really a bad idea,” said Emmett Reed, executive director of the association.

“I understand the free-market concept. But this is a public-private partnership. This is not a true free-market business we’re in.

He added: “I think that, philosophically, the governor wants to get it all on the table, to have the discussion. At the end of day, I think, he may have a reasonable ear for nursing homes when we discuss it with him.”

In other priorities, the association supports a proposed prospective payment reimbursement system — paying facilities on a per diem basis tied to factors including patient care and quality.

But it would like a three-year phase-in and more incentives to increase room size and build other improvements.

Additionally, representatives of the organization said, the state could save $68.2 million by exempting long-stay nursing home residents from Florida’s managed care system when it is demonstrated they can’t be moved to less intensive care settings.

Legislation introduced in Senate would tighten protections against AOBs

Legislation sought by regulators, insurance, and business interests to reform assignment of benefits agreements finally dropped Friday — and the first thing it would do is bar attorney fee awards to contractors who use those contracts to sue insurers.

“Nothwithstanding any other law, as to suits based on claims arising under property insurance policies, attorney fees may not be awarded … in favor of any person or entity seeking relief against the insurer pursuant to an assignment agreement,” the bill says.

The provision in SB 1038, by Dorothy Hukill and Kathleen Passidomo, would deliver a top priority for Insurance Commissioner David Altmaier and the insurance and business lobbies.

They blame litigation arising from AOB agreements for rising property insurance premiums, alleging abuse by unscrupulous contractors.

The measure also contains provisions shielding policyholders from abuse. For example, they could rescind any such agreement within seven days and would be shielded from liens by contractors seeking the difference between what the insurer pays and the cost of repairs.

Officials at the insurance office did not reply to a request for comment.

“OIR is leading the effort on the AOB legislation,” said Michael Peltier, spokesman for Citizens Property Insurance Corp. “We have been working closely with OIR and other stakeholders to put together a proposal we believe will meaningfully benefit consumers.”

Contractors have argued that they need AOBs to ensure they are paid.

And Jee Jacobson, vice chairman of the Florida Justice Association Property Insurance Committee, said in a written statement that the bill would burden policyholders.

“This irresponsible legislation picks insurance companies as winners and makes homeowners losers. It is the insurance industry’s wish list,” he said.

“Under this legislation, homeowners in desperate need of emergency repairs would have to either provide large amounts of cash up front, or face having liens placed on their property,” he said. “That is because contractors making emergency home repairs will no longer agree to deal directly with the homeowners’ insurance company for payment.”

The bill would require that policyholders be given a copy of any AOB agreement. It gives contractors three days to deliver copies to the insurance companies, and requires them to submit written, itemized cost estimates.

Contractors would be barred from charging cancellation fees or other administration fees.

Before a contractor could sue, he or she would have to submit to a deposition under oath about the work done, the costs, and the details of the AOB agreement. They could be forced into arbitration.

“Notwithstanding any other law, the acceptance by a person of any assignment agreement constitutes a waiver by the assignee or transferee … of any and all claims against all named insureds for payment arising from the specified loss,” the bill says.

“Except that all named insureds remain responsible for the payment of any deductible amount provided for by the terms of the insurance policy and for the cost of any betterment ordered by all named insureds.”

The provisions would not apply when a policyholder assigns insurance rights to someone who buys the property — or to management companies, family members, or guardians empowered to act on the policyholder’s behalf.

Trial attorneys support “efforts to curb problems with water mediation and other issues with first-party insurance,” but “taking away people’s property rights is not the answer to this problem,” Jacobson said.

“The solution is simple: Good contractors should be able to require Insurance companies to keep their word to their customers and stop denying and underpaying legitimate claims – and if they don’t, the homeowner shouldn’t have to be burdened with liens and lawsuits.”

Marion Hammer sees paths around 11th Circuit’s ‘Docs v. Glocks’ ruling

Gun-rights lobbyist Marion Hammer has denounced the 11th U.S. Circuit Court of Appeals’ “Docs v. Glocks” ruling as “activist,” and complained the court “treats gun owners as second-class citizens.”

“This activist decision attempts to use the First Amendment as a sword to terrorize the Second Amendment and completely disregards the rights and the will of the elected representatives of the people of Florida,” Hammer said.

“This is not necessarily the final word on these important issues, as the state of Florida has both legislative and appellate options to reinstate these important protections.”

Hammer released her reaction in an emailed statement Friday.

On the plus side, the federal appeals court on Thursday upheld a provision “prohibiting doctors from discriminating against gun owners,” Hammer said.

“Further, the court left intact the provision making it clear that patients have an absolute right to refuse to answer doctors’ questions about gun ownership. I’m sure anti-gun doctors are not happy about that.”

She described the law as “sensible and appropriate regulation of the medical profession that sought to protect gun owners from political harassment, and the medically irrelevant questioning and record-keeping about patients who are gun owners.”

She insisted: “The Legislature has every right to regulate any profession to protect the public from discrimination and abuse. Doctors are businessmen, not gods.”

The law, enacted in 2011, sought to prevent doctors from asking patients whether they own guns, on pain of professional discipline including possible loss of their licenses to practice.

Lobbyist’s blog post gets tongues flapping among Tallahassee’s lobbyist set

Who is Mary Beth Wilson?

That question buzzed around the lobbying shops on or near Tallahassee’s Adams Street after a blog post by a widely respected lobbyist accused a lobbyist for Demotech Inc. of posing as that “concerned citizen” to praise the ratings agency during a conference call.

The post said “most industry professionals” believe the caller was Lisa Miller, of Lisa Miller & Associates, who flatly denied it.

“No,” Miller said when asked whether she had done it. “I did not make that call.”

“Let me assure you that if this occurred, no one at Demotech coordinated it or scripted it,” Demotech president Joe Petrelli said by email.

Did Demotech organize any such thing?

“No,” Petrelli said. “We held a teleconference to explain our press release and take questions because we are transparent.”

Jeff Grady, president and CEO of the Florida Association of Insurance Agents, posted the blog (password protected) on Wednesday.

In it, he described Demotech as “practically the only ratings agency that matters to many insurers and banks that fuel residential real estate lending in our state.”

But he added that problems attending a recent conference call to discuss the prospect that the agency would downgrade some Florida insurers demonstrated that “Demotech isn’t quite ready for the big leagues.”

One reason was a comment by that concerned citizen, who identified herself as “Mary Beth Wilson” on the call, and praised Demotech and Petrelli.

“Although no official record of the call is available, it is practically undeniable that Mary Beth Wilson is not who she said she was,” Grady wrote.

“Most industry professionals believe her to be the paid, outside lobbyist for Demotech. You just can’t make this stuff up!”

He didn’t name Miller, but included a link to her lobbyist registration page, which identifies her as representing Demotech, among other clients.

“It’s important to note that Demotech does play a critical role in Florida’s residential property market; we would hardly have one if it did not exist,” Grady wrote.

“But if Demotech ever wants its company name to be uttered in the same breath as A.M. Best, it needs to conduct its business in a more professional and predictable manner. It shouldn’t need to hire someone to tell others how good the company is; its work product should say it all.”

Reached for comment, Grady said he’s known Miller for 15 years. “I know what she sounds like over the phone. There’s no mistaking who that was,” he said.

He conferred with “four or five” others who were on the call.

“Before I could ask about it, they were laughing — they knew who Mary Beth Wilson was. It was funny, but not so funny,” Grady said.

Demotech is “a pretty critical component of our real estate lending market,” he said. “To have someone who’s a paid representative kind of feign some comments on the call — why not just identify yourself?”

Grady knew the post would stir the pot. “I figured it might, but it couldn’t go without saying.”

Lobbyists — many of whom have bumped elbows with Miller in the past — were astonished at the alleged subterfuge, coming while the Legislature considers assignment of benefits reforms targeting fraud.

“It completely undermines the AOB piece,” one lobbyist said. “It finally starts gaining traction and here you’ve undermined it by doing something like that.”

House and Senate leaders reached for comment haven’t responded yet.

Demotech hadn’t posted a recording of the conference call as of Thursday afternoon.

“We are assessing the quality of the recordings and may post them to our site at a later date,” Petrelli said. “If we do so, we will issue a release indicating audio is available.”

Do you plan to take any action in response to the assertion?

“At this time, we do not plan to take action in response to the unverified assertion,” he said.

Supreme Court limits information insurers may demand under PIP policies

The Florida Supreme Court has taken a narrow view of the amount of evidence hospitals and other health care providers are obliged to turn over to insurance companies concerning the reasonableness of personal injury protection claims.

In a unanimous ruling, the court sided with the 1st District Court of Appeal over the 4th District Court of Appeal, which had issued conflicting interpretations of Florida’s PIP statute.

“We conclude that discovery is limited to the production of a written report of the history, condition, treatment, dates, and costs of such treatment of the injured person and why the items identified by the insurer were reasonable in amount and medically necessary, together with a sworn statement, as well as the production, inspection and copying of records regarding such history, condition, treatment, dates, and costs of treatment,” Chief Justice Jorge Labarga wrote.

“Furthermore, we agree that (the statute) provides limited pre-litigation discovery into specified information about the treatment and charges for treatment provided to an injured party, and that the discovery tools found in the rules of civil procedure … are not triggered until litigation over the reasonableness of those charges has ensued.”

Justice C. Alan Lawson, who only recently joined the court, did not participate.

The dispute in State Farm Mutual Automobile Insurance Co. v. Shands Jacksonville Medical Center Inc. centered on the insurer’s attempt to collect information about the treatment afforded 29 insured following auto accidents.

Florida’s PIP statute allows insurers “discovery of fact” — meaning access to provider records to determine whether the treatment was reasonable.

Shands delivered medical records, documents detailing treatments and charges, its Medicare cost report, and data reflecting what other hospitals charged for the same procedures.

Shands refused to turn over copies of third-party documents covering discounts it had negotiated with other carriers. State Farm sued for those records. A trial judge ruled that the company was entitled to them.

The 1st DCA and the 4th DCA, in a similar dispute, disagreed about the amount of information Shands was obliged to turn over. The first court took a narrow view, holding that State Farm was entitled only to records spelled out in subsection 6 (a) — essentially, the information Shands had delivered.

The latter court took a more expansive view, ruling that the Florida Rules of Civil Procedure’s broader discovery rules applied.

The Supreme Court agreed with the 1st DCA that the Legislature intended the statute to afford a “limited pre-litigation procedure for a PIP insurer to obtain specified information about the treatment provided to its insured and the charges for that treatment.”

Appeals court reverses ruling striking limits on PIP payments to chiropractors

A state appeals court has upheld a law limiting payments to chiropractors under reforms to Florida’s personal-injury protection insurance system the Legislature approved in 2012.

The 3rd District Court of Appeal on Wednesday reversed a ruling by Miami-Dade County Circuit Judge Michaelle Gonzalez-Paulson holding that the limits were unconstitutional.

“We must presume that the Legislature conducted its own evaluation of the respective professionals’ qualifications,” the appeals court wrote.

“When no suspect class or fundamental right is implicated, our inquiry is limited to whether the law bears a reasonable relationship to a legitimate governmental objective. Plainly, the reduction of fraud in order to lower the cost of insurance premiums is a valid governmental objective.”

The case is Garrido v. Progressive American Insurance Co.

Chiropractor Eduardo Garrido, armed with an assignment of benefits agreement signed by patient injured in an accident, challenged the law’s exclusion of chiropractors from the list of medical professionals qualified to diagnose an emergency medical condition.

The law allows only a licensed doctor, osteopath, dentist, or physician’s assistant to render that diagnosis, which would have qualified Garrido to bill for up to $10,000 under his patient’s PIP coverage.

Since Garrido was not authorized to make the diagnosis, the company paid him only $2,500 against his $6,075 bill.

Gonzalez-Paulson concluded the limit was unconstitutional on equal-protection and due-process grounds.

The appeal court, in a unanimous ruling by Chief Judge Richard Suarez, cited “a strong presumption of validity if there is a rational relationship between the disparity of treatment of those persons or groups and a legitimate governmental objective.”

In this case, the court said, that was “to reduce fraud in order to lower the cost of insurance premiums.”

The separation-of-powers doctrine obliges courts to defer to reasonable legislative decisions, the court continued.

“Courts are required to give great deference to legislative policy choices, and it constitutes reversible error for a trial court to subject legislative fact-finding to courtroom fact-finding standards,” the court said.

“In this vein, and recognizing the hallmark constitutional principle of separation of powers, even laws that a judge perceives ‘as unwise or unfair’ pass constitutional muster under the rational-basis test.”

Senate may balk at Rick Scott’s plan to hit hospitals over charity care

Gov. Rick Scott‘s proposal to cut Medicaid reimbursement payments to profitable hospitals that stint on charity care may run into trouble in the Senate.

During hearings Wednesday before the Appropriations Subcommittee on Health and Human Services, members including Chairwoman Anitere Flores raised objections.

“The governor’s office has made some assumptions, based on the fact that some hospitals are very profitable, that they can afford a cut,” Flores said following the meeting.

“I’m hearing very different things from our local hospitals,” she said. “I think you heard from other members that they have some concerns, as well.”

Scott’s $83.4 billion spending plan would save $298 million “by eliminating arbitrary and inconsistent supplemental payments for hospitals that provide less charity,” according to a summary available here (scroll down to page 27.)

Aides to the governor briefed committee members on his asks for the agencies for Health Care Administration and Persons with Disabilities; and the departments of Children and Families. Elder Affairs, Health, and Veterans’ Affairs.

Also Wednesday, the panel began hearing from advocates seeking state support for local projects. House Speaker Richard Corcoran started insisting on full hearings for member projects in the budget this year, but Flores said the Senate began such hearings last year.

Projects presented include programs for older Floridians, veterans, people suffering drug addiction and mental problems, and children.

For example, The Arc Nature Coast sought $425,000 to replaced a 58-year-old farm house with a new center to house and serve 75 former Sunland residents from Hernando and Pasco counties; and Tallahassee’s Apalachee Center sought $1 million to provide forensic mental health services people in eight counties, rather than send them to the Florida State Hospital in Chattahoochee.

Flores said the exercise was a way for programs to “make their case to the Legislature.”

Show Buttons
Hide Buttons